Mortality and morbidity in lead smelter workers with concomitant exposure to arsenic

Arsenic is a well-known lung carcinogen in humans. In 2006, IARC upgraded inorganic lead as a possible human carcinogen (2A). The aim of this thesis has been to evaluate the lung cancer mortality and incidence in long-term exposed primary lead smelter workers and also to estimate present exposures to arsenic and lead in relation to those occurring in the past. The basic cohort (N=3832 workers; hired before 1967 and followed up from 1950-1981; SMR comparisons with general and local reference populations) showed an excess of deaths for total mortality, malignant neoplasms (e.g. lung and stomach cancer), ischaemic heart diseases, and cerebrovascular diseases compared to the general population. In a subcohort of lead workers (N=437; regular blood lead sampling since 1950) only the raised SMR for lung cancer (162) was sustained. In a follow-up study of the basic cohort (N=3979), a subcohort of lead exposed workers (N=1992) was formed. The expected mortality in 1955-1987 and cancer incidence in 1958-1987 were calculated relative to county rates. A cumulative blood lead index (CBLI) was used for dose-response analyses. The lung cancer incidence was raised in the total cohort (SIR 2.8; 95 % CI 2.1 3.8). A higher lung cancer risk was observed in workers hired before 1950 (SIR 3.6; 95 % CI 2.6-5.0). The increased lung cancer risks were further elevated in the subcohort of lead exposed workers, especially in the highest exposed subgroup (SIR 5.1; 95 % 2.0-10.5; latency period of 15 y). No excesses of other malignancies were observed. The increased relative risks for lung cancer may have been caused by interactions between inorganic lead and other substances at the smelter, e.g. arsenic. To further analyze the effects from inorganic lead, two subcohorts of workers at the lead departments were formed from the original cohort (N=3979), one of 710 workers and the other of 383 workers. The lung cancer incidence was raised in both subcohorts (Lead subcohort 1; SIR 2.4; 95 % CI 1.2-4.5; Lead subcohort 2; SIR 3.6; 95 % CI 1.2-8.3). Among the 10 workers that had developed lung cancer in lead subcohort 1 all but one had a considerable exposure also to arsenic. Thus, a possible interaction effect between lead and arsenic may explain the increased lung cancer risks. To further elucidate the impact from lead and arsenic a case control study was undertaken. In the basic cohort (N=3979), 46 male workers had contracted respiratory malignancies. They were compared with 141 agematched male referents from the primary smelter by conditional logistic regression analysis using smoking habits, cumulative blood lead and air arsenic exposure as predictor variables. The lung cancer cases showed a significantly higher smoking rate than referents (Odds ratio, OR = 4.0; 95 % CI 1.6-10.1; p=0.003). When restricted to smokers, the cumulative arsenic air exposure index, but not the lead exposure indices, were significantly higher among the cases (OR=1.07; 95 % CI 1.02-1.11; p = 0.005). Accordingly, cumulative arsenic exposure and smoking were identified as significant risk factors for the development of lung cancer in the final analyses, while lead exposure was not a significant risk factor. However, inorganic lead still may play a minor role in the multifactorial genesis of lung cancer. These studies describe risks from exposures occurring from time periods before 1950 up to 1981. Because of the long latency period for lung cancer, exposures after 1970 probably have had limited impact on the reported results. Compared to the levels in the early 1970´s present exposures to arsenic are lower by a factor of ten or more and risks probably correspondingly lower

Hälsoeffekter av svaveldioxid : en litteraturstudie med betoning på de senaste årens publikationer

Föreliggande rapport sammanfattar WHO:s senaste riktlinjer (WHO 2006) för luftkvalitet.Vidare redovisas en litteraturstudie rörande publikationer under de senaste åren angåendeexponering för SO2 och olika hälsoeffekter särskilt astma. Bakgrunden till rapporten är det beslut angående Boliden AB´s verksamhet vidRönnskärsverken som träffades i Koncessionsnämnden 1998 06 16. I det kontrollprogramsom föreskrevs av Koncessionsnämnden skall ingå undersökningar hur korttidsvärden avsvaveldioxid varierar samt en karaktärisering av stoftutsläpp från verksamheten. Utförda mätningar av SO2 under slutet av 1990-talet och början av 2000-talet innebär intenågot överskridande av gällande miljökvalitetsnorm. Eftersom denna norm bygger på tidigarepublicerad vetenskaplig litteratur är det angeläget att undersöka om nyare studier geranledning till större restriktivitet angående utsläpp av SO2. WHO har uppdaterat sina riktlinjer för luftkvalitet (WHO 2006). Enligt de nya riktlinjernarekommenderas gräns för luftföroreningar (SO2) till 20 μg/m3 som 24 timmars medelvärdeoch 500 μg/m3 som tio minuters medelvärde. Det är väl känt sedan tidigare att det finns ett samband mellan astmasymtom och exponeringför SO2 i luftföroreningar. Det har dock rått oklarhet om SO2 kan förorsaka astma eller om detär så att astmaanfall utlöses av förhöjda SO2 nivåer i luften hos personer som fått astma avandra anledningar. En rad epidemiologiska studier, som delvis omnämns i föreliggande rapport, har visat påsamband mellan korttidshalter av SO2 och andra luftföroreningar och sjukhusinläggningar. Den genomförda litteraturgenomgången visar att ett avsevärt antal studier finns publiceradeunder de senaste åren angående luftföroreningar, särskilt SO2 och astma. Det framgår i mångaav dessa studier att en ökning av astmasymtom har relaterats till ökande halter avluftföroreningar i städer. Vilken roll olika luftföroreningskomponenter spelar för uppkomstenav symtom framgår dock inte klart i de publicerade studierna. WHO 2006 rekommenderade en riktlinje på 20 μg/m3 som dygnsmedelvärde för SO2 och destudier som publicerats 2006-2009 ger ytterligare stöd för denna uppfattning

Eldningsvanor inom några studieområden i Västerbotten

I syfte att få bättre underlag om vedeldningens omfattning och emissioner har en eldningsvaneundersökning genomförts i fyra områden inom Västerbotten. Undersökningen baseras på en besöksintervju genomförd av två personer vilka följt ett formulär med frågor och standardiserat sina klassificeringar av de intervjuades svar av mer öppen karaktär. Intervjuerna har genomförts i fyra områden med bebyggelse av olika ålder: Vännäs (kommuncentra), Vännäsby, Sävar och Tavleliden/Tomtebo (villaförort i Umeå). På dessa platser har partikelmätningar i en punkt genomförts inom ramen för ett annat projekt, och kortvariga sotmätningar genomförts på fler platser. Hushåll till intervjuerna utvaldes utifrån att de enligt sotarregistret har någon form av ved- , flis- eller pelletseldning. Totalt intervjuades 176 hushåll, endast ett två ytterligare var tillfrågade och avböjde. Studien visar anläggningarnas användningsgrad, bl.a. bränsleförbrukning per år, vilket kan användas för att beräkna utsläppsmängder. För pannor fanns dock inget samband mellan hög sotnings-frekvens enligt sotarregistren och hög vedförbrukning per år enligt intervjuerna. De som har fjärrvärme som huvudsakligt uppvärmningssätt använder sin kamin/lokaleldstad mindre än den som i huvudsak värmer bostaden med el. Utsläpps- och haltberäkningar kan ta hänsyn till denna kunskap

Cadmium biomonitoring and renal dysfunction among a population environmentally exposed to cadmium from smelting in China (ChinaCad).

Cadmium, an environmental pollutant, can have adverse effects on the human body. The kidney is the critical organ. In order to improve the understanding of the dose-response relationship between cadmium exposure and health effects, and especially renal dysfunction, a study on a general population group in China was performed. This study was therefore concerned with cadmium exposure biomarkers, such as the concentrations in blood (BCd) and urine (UCd), and effect biomarkers of renal dysfunction, such as beta2-microglobulin (beta2m), retinol binding protein (RBP) and albumin (ALB). To improve the evaluation of exposure levels in relation to the adverse health effects of cadmium exposure in the general population, a quality control program was conducted to determine analytical quality in the determination of cadmium in blood and urine and for beta2m, creatinine, ALB and RBP. The measurements showed that analytical quality was adequate. The exposure and effect biomarkers were studied in the population groups living in three areas, namely a control area and two Cd polluted areas. In the highly exposed area, most of the BCd values were higher than 5 microg/l and most of the UCd values were higher than 5 microg/g creatinine. Beta2-microglobulin, retinol binding protein, and albumin in urine were all significantly higher in the population living in the heavily polluted area than in that in the control area. Based on data from all three areas, a marked dose-response relationship between UCd or BCd and the prevalence of renal dysfunction was demonstrated. The number of abnormalities in kidney was related to the level of cadmium exposure. Only one index of renal tubular dysfunction was affected in subjects exposed to low levels of cadmium, but more than two indices of renal function were affected in those exposed to high levels

Lung function in volunteers before and after exposure to trichloramine in indoor pool environments and asthma in a cohort of pool workers

OBJECTIVES: Exposure to trichloramine (NCl(3)) in indoor swimming-pool environments is known to cause mucous membrane irritation, but if it gives rise to changes in lung function or asthma in adults is not known. (1) We determined lung function in volunteers before and after exposure to indoor pool environments. (2) We studied the occurrence of respiratory symptoms and asthma in a cohort of pool workers. DESIGN/METHODS/PARTICIPANTS: (1) We studied two groups of volunteers, 37 previously non-exposed healthy persons and 14 pool workers, who performed exercise for 2 h in an indoor pool environment. NCl(3) in air was measured during pool exposures and in 10 other pool environments. Filtered air exposures were used as controls. Lung function and biomarkers of pulmonary epithelial integrity were measured before and after exposure. (2) We mailed a questionnaire to 1741 persons who indicated in the Swedish census 1990 that they worked at indoor swimming-pools. RESULTS: (1) In previously non-exposed volunteers, statistically significant decreases in FEV(1) (forced expiratory volume) and FEV(%) (p=0.01 and 0.05, respectively) were found after exposure to pool air (0.23 mg/m(3) of NCl(3)). In pool workers, a statistically significant decrease in FEV(%) (p=0.003) was seen (but no significant change of FEV(1))(.) In the 10 other pool environments the median NCl(3) concentration was 0.18 mg/m(3). (2) Our nested case/control study in pool workers found an OR for asthma of 2.31 (95% CI 0.79 to 6.74) among those with the highest exposure. Exposure-related acute mucous membrane and respiratory symptoms were also found. CONCLUSIONS: This is the first study in adults showing statistically significant decreases in lung function after exposure to NCl(3). An increased OR for asthma among highly exposed pool workers did not reach statistical significance, but the combined evidence supports the notion that current workroom exposures may contribute to asthma development. Further research on sensitive groups is warranted

Platinum, palladium, rhodium, molybdenum and strontium in blood of urban women in nine countries

Background: There is little reliable information on human exposure to the metals platinum (Pt), palladium (Pd) and rhodium (Rh), despite their use in enormous quantities in catalytic converters for automobile exhaust systems. Objectives: To evaluate blood concentrations of Pt (B-Pt), Pd (B-Pd) and Rh (B-Rh) in women from six European and three non-European countries, and to identify potentially influential factors. In addition, molybdenum (Mo) and strontium (Sr) were analysed. Methods: Blood from 248 women aged 47-61 was analysed by high resolution inductively coupled plasma mass spectrometry under strict quality control. Results: The medians were: B-Pt 0.8 (range <0.6-5.2), B-Pd <5 (<5-9.3), B-Rh <0.4 (<0.4-3.6). ng/L and B-Mo 2.0 (0.2-16) and B-Sr 16.6 (3.5-49) μg/L. Two women with highly elevated B-Pt (242 and 60. ng/L), previously cancer treated with cis-platinum, were not included in the data analysis. All elements varied geographically (2-3 times) (B-Pd P = 0.05; all other elements P. <. 0.001); variations within each area were generally 5-10 times. Traffic was not associated with increased concentrations. Conclusions: General population blood concentrations of Pt, Pd and Rh are within or below the single digit ng/L range, much lower than in most previous reports. This is probably due to improved analytical performance, allowing for more reliable information at ultra-trace levels. In general, Mo and Sr agreed with previously reported concentrations. All elements showed geographical and inter-individual variations, but no convincing relationships with self-reported traffic intensity were found. Pt from the antineoplastic drug cis-platinum is retained in the body for years